Vision, leadership and partnership: how to enhance the nursing and midwifery contribution to research and development

Nurses' experiences of participation in a research and development programme

AIMS AND OBJECTIVES

To describe clinical nurses' experience of participating in a Research and Development (R&D) programme and its influence on their research interest and ability to conduct and apply nursing research.

BACKGROUND

To stimulate nurses' research interest and to overcome barriers for building research capacity in nursing, there is a need for sustainable research programmes. A two-year programme was designed for nurses, to take part in both an academic education for master and research seminars and workshops to conduct a research project from idea to publication.

DESIGN

A qualitative approach using using focus group interviews.

METHODS

Registered nurses (n=12) with a bachelor's degree in nursing, participated. Data were collected in focus group interviews, after one year and when the programme ended. Content analysis was used to analyse the data.

RESULTS

The findings consist of two themes: being a traveller in the world of nursing research, which included three categories, and experiencing professional growth as a result of nursing research training, in both cases focusing on the experience of students involved in a cohesive programme which included four categories: discovering new dimensions of clinical nursing practice; selected and confirmed; supported by professional others; development of professional self-concept.

CONCLUSIONS

To support early career researchers, there is a need for strong leadership, an organisational and supportive infrastructure underpinning research capability building in nurses. In this context, research strategies, programmes and collaboration between leaders of academia and clinical institutions appear to be essential.

RELEVANCE TO CLINICAL PRACTICE

The R&D programme illustrates an effective way of stimulating nurses' lifelong learning by building the capacity to conduct and apply nursing research in clinical practice. The structure of the programme can be used as a model in other contexts.

The International Confederation of Midwives essential competencies for basic midwifery practice. an update study: 2009-2010

OBJECTIVE

a 2-year study was conducted to update the core competencies for basic midwifery practice, first delineated by the International Confederation of Midwives in 2002. A competency domain related to abortion-related care services was newly developed.

DESIGN

a modified Delphi survey process was conducted in two phases: a pilot item affirmation study, and a global field survey.

SETTING

a global survey conducted in 90 countries.

PARTICIPANTS

midwifery educators or clinicians associated with midwifery education schools and programmes located in any of the ICM member association countries. Additional participants represented the fields of nursing, medicine, and midwifery regulatory authorities. A total of 232 individuals from 63 member association and five non-member countries responded to one or both of the surveys. The achieved sample represented 42% of member association countries, which was less than the 51% target. However, the sample was proportionally representative of ICM's nine global regions.

MEASUREMENTS

survey respondents expressed an opinion whether to retain or to delete any of 255 statements of midwifery knowledge, skill, or professional behaviour. They also indicated whether the item should be a basic (core) item of midwifery knowledge or skill that would be included as mandatory content in a programme of midwifery pre-service education, or whether the item could be added to the fund of knowledge or acquired as an additional skill by those who would need or wish to include the item within the scope of their clinical practice.

FINDINGS

a majority consensus of .85 was required to accept the item without further deliberation. An expert panel made final decisions in all instances where consensus was not achieved. The panel also amended the wording of selected items, or added new items based on feedback received from survey respondents. The final document contains 268 items organised within seven competency domains.

Choice in maternity: rhetoric, reality and resistance

OBJECTIVE

to inform the organisation of the maternity services in Scotland, a phenomenological study was planned to examine maternity decision making in two similarly small countries. The aim was to examine the experience of contributing to decisions at clinical, organisational and policy-making levels. When examples were needed the informants were asked to use their experience of place of birth decisions.

DESIGN

a hermeneutic phenomenological approach was employed. In-depth, semi-structured conversations were used. The fieldwork extended over a 4-month period in 2005. The data were analysed using Colaizzi's method.

SETTING

Finland and New Zealand were chosen because the parallels in their health care and maternity care systems would limit disparities. In one of the Finnish centres, the findings were particularly homogeneous and exemplified many of the issues arising in other settings. The findings of the fieldwork in this Finnish centre are the focus of this paper.

PARTICIPANTS

the informants were mothers, midwife managers/policy makers, midwives and other maternity care providers. The findings of 12 conversations, including mothers and all groups of staff, are reported here.

FINDINGS

the background theme which emerged was 'trusting the system'. The informants were aware of the extent to which change is happening. One of the sub-themes contrasted the informants' perceptions of their lack of strength and courage with Finnish stereotypes. Being safe proved to be another crucial issue. The final sub-theme was 'playing the system'.

KEY CONCLUSIONS

trust in a well-respected health-care system was necessary for the informants to be able to subvert or resist that system. While such resistance has been documented in other disciplines, such as nursing, reference has not been found in relation to maternity. The resistance to the system was, at the time of the fieldwork, neither co-ordinated nor collaborative.

IMPLICATIONS FOR PRACTICE

the findings of this study carry important implications for women's and midwives' input into maternity care.

Development of a critical care nursing research strategy: a tripartite approach

The building of nursing research capacity is important, as it improves the quality of nurse education, the talent of nurses and the standard of patient care. A local critical care nursing research strategy was developed using a tripartite model applied to practice. This was a collaborative approach to critical care research as a model to direct, deliver, facilitate and support nursing research in practice through planned and protected investment in nursing research time. The tripartite model was evaluated and recommendations made with the aim of sharing findings so that other nurses can utilize these experiences to set up similar secondment opportunities for the promotion of nursing research.

Capacity building in nursing and midwifery research and development: an old priority with a new perspective

AIM

This paper is a report of a study to identify strategic priorities to inform the development of a regional strategy for nursing and midwifery research and development.

BACKGROUND

Research capacity has been highlighted internationally as a crucial element in the advancement of nursing and midwifery research and development. Research capacity has been defined as that which relates to the ability to conduct research. In a strategic context, however, there is a broader perspective that encompasses activities related both to 'using' and 'doing' research.

METHODS

A modified nominal group technique was employed. Three rounds were used to identify the main strategic priorities for nursing and midwifery research and development. Round one was based on the Delphi Technique and further rounds were based on the nominal group technique approach. Data were collected during February 2005. Participants (n = 105) were those involved in the research and development agenda for nursing and midwifery in Northern Ireland.

FINDINGS

Capacity building was highlighted as a central component from the final 12 priorities, with three key areas identified: (1) the importance of strong and visible leadership; (2) developing research expertise that will enable the profession to deliver programmes of research and (3) increasing the capacity of individuals and organizations to engage in development activity.

CONCLUSION

The 12 priorities identified emphasize the need for a broad perspective on building capacity that reflects involvement in a range of activities that span 'research' and 'development'. This has important implications globally if nurses and midwives are to develop the knowledge and skills required to engage in research and development as an integral part of their practice. Embracing this broader perspective has the potential to enhance performance that will contribute to continuous quality improvement.